Neoadjuvant hormonal deprivation for patients undergoing radical prostatectomy

Asian J Androl. 2009 Jan;11(1):127-30. doi: 10.1038/aja.2008.16. Epub 2008 Dec 1.

Abstract

The purpose of this study is to evaluate the therapeutic effect of radical prostatectomy combined with preoperative neoadjuvant hormonal ablation therapy for prostate cancer (PCa). In this study, a total of 31 patients with local PCa underwent radical prostatectomy; of these, 12 patients underwent preoperative hormonal deprivation with a combination of goserelin and flutamide for a period of 5.6 months. Data regarding clinical characteristics were compared between the neoadjuvant therapy and radical prostatectomy groups. A total of 31 patients received pelvic lymph node clearance, and the rate of positive lymph nodes was 12.9% (4/31). Serum prostate-specific antigen (PSA) was 8.9 +/- 1.2 microg L(-1) after the neoadjuvant therapy and 0.4 +/- 0.3 microg L(-1) one month after the radical prostatectomy. There were significant differences in the positive surgical margins, seminal vesicle invasion and lymph node metastasis between the neoadjuvant therapy group (n = 12) and the radical prostatectomy group (n = 19, P < 0.01). The resulsts indicates that preoperative hormonal deprivation induced by goserelin and flutamide can decrease clinical and pathological staging, but assessment of its influence on long-term prognosis requires further study.

MeSH terms

  • Aged
  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Combined Modality Therapy
  • Dose-Response Relationship, Drug
  • Flutamide / therapeutic use*
  • Goserelin / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Neoadjuvant Therapy / methods*
  • Prostate-Specific Antigen / blood
  • Prostatectomy / methods*
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / drug therapy*
  • Prostatic Neoplasms / surgery*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Hormonal
  • Goserelin
  • Flutamide
  • Prostate-Specific Antigen